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Heart rate variability for assessing comatose patients with different Glasgow Coma Scale scores
Yazmina Machado-Ferrer1, Mario Estévez, Calixto Machado
1Manuel Fajardo Rivero Hospital, Havana, Cuba. braind@infomed.sld.cu
Summary
Heart rate variability (HRV) significantly decreases in comatose patients, reflecting autonomic nervous system (ANS) dysfunction. This minimally invasive method effectively assesses ANS status in coma.
Area of Science:
- Neurology
- Cardiology
- Physiology
Background:
- The autonomic nervous system (ANS) plays a crucial role in maintaining physiological homeostasis.
- Assessing ANS function in comatose patients is challenging due to their altered state of consciousness.
Purpose of the Study:
- To evaluate the utility of heart rate variability (HRV) in assessing autonomic nervous system (ANS) function in comatose individuals.
- To correlate HRV parameters with the depth of coma as indicated by the Glasgow Coma Scale (GCS).
Main Methods:
- Studied 16 comatose patients and 22 healthy controls, matched for age and gender.
- Calculated time, frequency, and informational domain HRV indices.
- Classified comatose patients into subgroups based on GCS scores (GCS=3).
Main Results:
- Comatose patients exhibited a significant reduction in overall HRV compared to controls.
- Specific time-domain indices (triangular index, Delta_RRs) and frequency-domain powers (VLF, LF) were significantly reduced in patients with GCS=3.
- The LF/HF ratio and Shannon's entropy indices were also significantly decreased in the severe coma subgroup, indicating sympathetic-vagal imbalance.
Conclusions:
- HRV analysis is a potent and minimally invasive tool for evaluating ANS function in comatose patients.
- HRV parameters correlate with the severity of coma, reflecting progressive ANS dysfunction.
- HRV offers a low-cost, accessible method for ANS assessment in clinical settings involving coma.
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